# The Role of Sphingolipids in Myocardial Recovery Mediated by Mechanical Unloading and Circulatory Support

## TL;DR

This study explores how sphingolipids in the blood and heart tissue relate to heart recovery in patients using LVAD devices for advanced heart failure.

## Contribution

The study identifies specific sphingolipids as potential therapeutic targets for myocardial recovery after LVAD support.

## Key findings

- Nonresponders to LVAD had elevated circulating ceramides, while responders showed reduced S1P levels.
- Cardiac tissue from nonresponders showed increased S1P levels, suggesting a link to recovery likelihood.
- Sphingolipid metabolic pathways are implicated as potential therapeutic targets for myocardial recovery.

## Abstract

•The circulating and cardiac sphingolipid profiles in patients showing myocardial recovery following LVAD support are described.•Circulating dhCer(16:0) associated with functional and structural changes in advanced HF following LVAD support.•We identify circulating and cardiac Cer and S1P as potential therapeutic targets for myocardial recovery.

The circulating and cardiac sphingolipid profiles in patients showing myocardial recovery following LVAD support are described.

Circulating dhCer(16:0) associated with functional and structural changes in advanced HF following LVAD support.

We identify circulating and cardiac Cer and S1P as potential therapeutic targets for myocardial recovery.

Myocardial recovery after left ventricular assist device (LVAD) support is a critical phenomenon that allows advanced heart failure patients to retain their native heart. We quantified targeted sphingolipids in serum and cardiac tissue of patients who exhibited recovery post-LVAD. Our analysis revealed sustained elevated circulating ceramides levels in nonresponders post-LVAD, whereas responders showed reduced sphingosine-1-phosphate (S1P) levels. In contrast, cardiac tissue from nonresponders displayed increased S1P levels. We suggest that diminished ceramide and S1P may contribute to an increased likelihood of recovery after LVAD support. Collectively, our findings implicate the sphingolipid metabolic pathway as a potential therapeutic target to promote myocardial recovery after mechanical support.